As the surgeon general of the Navy, I am in awe of the young sailors and Marines who serve so gallantly. My most solemn days are those when I see a shipmate fall from wounds or illness. I also have the solemn task on occasion to review the case of a vibrant sailor or Marine who played Russian roulette with synthetic drugs such as “spice” or “bath salts” and lost, costing them their career, future and possibly life.

Sadly, this is no different from the real game where a round eventually chambers, and all is lost.

The issues that keep me up at night are the ones that have the most impact on personnel readiness and our ability to help sailors and Marines meet their missions. For me, undoubtedly the prevalence and growing popularity of synthetic forms of drugs like marijuana, the most common of which are spice and, in more recent months, bath salts, is one of those issues. These products are enough of a concern in our society that the federal government placed a ban on the sale of these man-made designer compounds earlier this month.

The U.S. military represents a microcosm of our much larger population and in many ways strives to be a reflection of the society we serve, so we share many of the same health and safety issues as the general population, including the increased use of these dangerous and debilitating drugs — which not only affect our service members’ health, but also our readiness as a military force. For nearly a year now, Navy leaders have taken a multitiered approach to combating this escalating issue in our forces, and with our partners in the Naval Criminal Investigative Service, Naval Personnel Command and throughout our naval enterprise, we have made progress in deterring and detecting use.

The challenge remains though, as these drugs are easy to obtain and are falsely marketed by manufacturers as a safe way to get high while avoiding drug detection. It is important for sailors and Marines to know that despite manufacturer claims, we can and are testing for these drugs.

The chemicals found in these drugs are not regulated by the U.S. Food and Drug Administration and no two batches are alike, meaning it is nearly impossible to determine the drug’s potency. Most packaging clearly reads, “Not for human consumption,” and that is for good reason. Military and civilian health professionals continue to learn more about the negative health effects of synthetic drug use, and the data are alarming.

Bath salts are essentially chemically engineered products meant to stimulate the central nervous system — similar to drugs such as methamphetamine, cocaine and Ecstasy.

Detrimental effects of the drug, which is also marketed as “plant food” or “herbal incense,” include but are not limited to extreme paranoid delusions and hallucinations, anxiety, agitation, aggression, tremors, seizures and dysphoria.

Unlike marijuana, the synthetic chemicals in spice-type products are more potent to the brain and other organs because they bind themselves more permanently to receptors. Spice could have multiple unknown chemicals including harmful metal residues, with unknown potency potentially five to 200 times more potent than the THC in marijuana. Users are also experimenting by combining different products, which can dramatically change or increase the effects. Rapid tolerance in some users can lead to increased dosage and addiction, either physical or psychological. According to the DEA, increased use of spice and other synthetics has led to a surge in emergency room visits and calls to poison control centers.

Spice has been reported to cause elevated blood pressure, tremor, seizures, vomiting, abdominal pain and more. Several episodes of heart damage have been reported with spice use, as well as several reports of persistent psychotic symptoms, hallucinations and paranoid behavior lasting several days and in some cases months.

There have also been civilian deaths and reported suicides associated with the use of synthetic drugs. Our medical providers have witnessed and treated many of these reported symptoms at military treatment facilities. As the leader of the medical community for the Navy and Marine Corps, I cannot emphasize enough to our sailors and Marines that using synthetic drugs really is just like playing Russian roulette with their health, not to mention their career.

While the main danger of synthetic drugs is the adverse and possibly life-threatening health effects, their use can also cost sailors and Marines their careers. Navy and Marine Corps personnel who wrongfully possess, use, promote, manufacture or distribute designer drugs or products containing synthetic cannibinoid compounds such as spice or paraphernalia may be subject to punitive action under Articles 92 and 112a of the Uniform Code of Military Justice, adverse administration action, or both. Consumption of any of these products meets the criteria for drug abuse and is prohibited.

Manufacturers constantly change product ingredients and market products under new names. However, as I said before, we can and do test for these drugs now. In March, we started screening for spice and more recently for bath salts. We have tested more than 6,500 samples since then and while a relatively minor percentage have come back positive, sailors and Marines need to know they are putting their careers at risk if they partake in these activities. In the past year alone, hundreds of sailors were held accountable for use or possession of these products. One-time use is enough for discharge from service. These incidents are not restricted to one type of platform, command or location either.

To deter drug abuse, I have urged all commanding officers and others in positions of leadership to be fully engaged in their command’s implementation plan to continually communicate and educate all hands as to the Navy’s zero-tolerance policy on synthetic designer drugs. Each command’s aggressive awareness and education campaign should begin during indoctrination and be reinforced throughout the year. We cannot over-communicate this issue. Accountability for those who abuse these substances will help deter their abuse.

Given the rise in usage, deterring synthetic drug abuse must be an all-hands effort. But as I mentioned before, this is not just a military issue. I implore everyone to take care when making decisions about using synthetic drugs. It’s not healthy. It’s not legal. It’s not worth it.

I can promise that Navy Medicine will continue to shine a light on this growing concern by delivering sustained, coordinated, aligned and targeted messages throughout the Navy and Marine Corps to ensure every person representing our armed forces is fully informed of the dangers of synthetic drugs, and I encourage my civilian medical counterparts to do the same in their communities.

It is my honor to serve as the surgeon general of Navy Medicine — a team made up of great men and women providing world-class care … anytime, anywhere.

Vice Adm. Matthew L. Nathan, U.S. Navy surgeon general and chief, Bureau of Medicine and Surgery, wrote this commentary for U-T San Diego.